PSI Senior Vice President for Malaria Control and Child Survival Dr. Desmond Chavasse blogs about his recent trip to Cambodia and PSI’s work to eliminate drug-resistant malaria in Southeast Asia. Part 3 of 3.
I first met Bill Gates for dinner in Nairobi in 2008. His foundation was providing funding to the PSI-led ACTwatch project, which monitors antimalarial drugs on the markets of up to 13 countries across Africa and Southeast Asia. During my dinner with Bill, I could not resist the temptation to play the “If I were you, I would spend my money on…” game.
May marks the beginning of one of the two rainy seasons here in Haiti. With rain come mosquitoes. At PSI, as with other public health programs, this is a time when we put more emphasis on water-borne illnesses, hygiene, sanitation and diseases like malaria and dengue fever. Now, we add Chikungunya to that list.
Today, for World Health Day this year, the World Health Organization has chosen to highlight the serious and increasing threat of vector-borne diseases. Every year, more than one billion people are infected and more than one million die from these diseases, which include malaria, dengue, leishmaniasis, lyme disease, schistosomiasis, and yellow fever, carried by mosquitoes, flies, ticks, water snails and other vectors.
The Global Fund to Fight AIDS, TB and Malaria is seeking to raise $15 billion in its new replenishment, this week. There will be a lot of discussions and reports about the vital organzation. Here are two new videos form the Center for Strategic International Studies out of Washington DC.
The first video looks at the Global Fund and the importance of the US as a major financial supporter to its work. This is a good video for those of you that are not familiar with the Fund. It answers the questions: what is the Fund and its mission? What impact has it had? What will it take to sustain its success?
Next up, Gayle Smith, Special Assistant to the President and a Senior Director at the National Security Council, explains why the Global Fund matters today and discusses the United States’ leadership role in supporting the Fund.
Some exciting developments in the quest to create a safe and effective malaria vaccine were announced at a conference in Durban, South Africa late yesterday afternoon.
The efficacy and public health impact of RTS,S were evaluated in the context of existing malaria control measures, such as insecticide treated bed nets, which were used by 78% of children and 86% of infants in the trial. In these latest results over 18 months of follow-up, children aged 5-17 months at first vaccination with RTS,S experienced 46% fewer cases of clinical malaria, compared to children immunised with a control vaccine. An average of 941 cases of clinical malaria were prevented over 18 months of follow-up for every 1,000 children vaccinated in this age group, noting that a child can contract more than one case of malaria. Severe malaria cases were reduced by 36%; 21 cases of severe malaria were prevented over 18 months of follow-up for every 1,000 children vaccinated. Malaria hospitalisations were reduced by 42%.
Infants aged 6-12 weeks at first vaccination with RTS,S had 27% fewer cases of clinical malaria. Over 18 months of follow-up, 444 cases of clinical malaria were prevented for every 1,000 infants vaccinated. The reduction of severe malaria cases and malaria hospitalisations by 15% and 17%, respectively, were not statistically significant.
“It appears that the RTS,S candidate vaccine has the potential to have a significant public health impact,” says Tinto. “Preventing substantial numbers of malaria cases in a community would mean fewer hospital beds filled with sick children. Families would lose less time and money caring for these children and have more time for work or other activities. And of course the children themselves would reap the benefits of better health.”
Overall, vaccine efficacy declined over time: Previous results from one year follow-up of the Phase 3 trial showed that efficacy of RTS,S was 56% against clinical malaria and 47% against severe malaria for the 5-17 month-old age group and 31% against clinical malaria and 37% against severe malaria in the 6-12 week-old age group.
The Global Fund to Fight AIDS, Tuberculosis and Malaria released their mid-year results for 2013. The numbers are very exciting.
More than 5.3 million people living with HIV receive ARVs thanks to the Global Fund. The findings also observe a 21% increase in the number of women treated to prevent mother-to-child transmission of HIV.
“These results show that we can have a transformative effect on these diseases, by working together,” said Mark Dybul, Executive Director of the Global Fund. “More people affected by HIV today can go to work, send their children to school and lead healthy lives thanks to the hard work of all our partners.”
Big strides have also been made in the fight against malaria, with 30 million insecticide-treated nets distributed in the first half of 2013 under programs supported by the Global Fund, taking the total number of nets distributed to 340 million. The number of cases of malaria treated rose to 330 million, a 13 percent increase.
Global Fund-supported TB programs also continued to expand. Global Fund financing has cumulatively supported detection and treatment of 11 million smear-positive cases of TB, up from 9.7 million at the end of 2012. The number of people treated for multidrug-resistant TB grew to 88,000 from 69,000 through Global-Fund supported programs. The World Health Organization reported that 56,000 cases were enrolled in treatment of multidrug-resistant TB globally in 2011, of which Global Fund-supported programs accounted for about 22 percent. India drove the leap forward, accounting for about 60 percent of the increase at the end of 2012.